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Conceiving After A Tubal Ligation

Tubal ligation, or “having your tubes tied,” is a process that involves obstructing the fallopian tubes either through clipping, banding, stitching or burning them. Fallopian tubes are the structures that carry the egg from the ovary to the uterus, and where the egg meets sperm for fertilization. A tubal ligation is a generally effective form of birth control because it is a physical barrier preventing the sperm from traveling up to the egg for fertilization and the egg from arriving in the uterus, which is where it grows into an embryo. Tubal ligation procedures can be done laparoscopically, post-partum or as part of an open procedure (i.e. during a cesarean section). It is usually an elective procedure done when the woman no longer wishes to have more children, or any children at all. On occasion a woman decides she would like to try to conceive after the procedure. For this to occur, the woman must either undergo in vitro fertilization or an additional surgery to reverse the original procedure.

When the tubal ligation is reversed, the interrupted fallopian tubes are rejoined. There is the possibility that the remaining severed tubes may not be long enough to reconnect or the tubes may be connected but too damaged to allow pregnancy to occur.

Successful reversal involves several factors including:

1) The length of the tube remaining after the original ligation, with greater than 5 cm having the highest success rate.

2) Female is less than 35 years of age

3) Acceptable sperm count for the male

Reversals are often done by reproductive surgeons, reproductive endocrinologists or gynecologists. Chances of an ectopic pregnancy are increased from 1% an average population to 5% in the population of women who have had a reversal.

In vitro fertilization bypasses the need for patent fallopian tubes by surgically removing the eggs from the woman, fertilizing them with sperm in the laboratory and then returning the growing embryos to the woman’s uterus. In vitro fertilization success rates may be affected by many factors, with the most important being the age of the woman at the time of egg retrieval. Individual clinic success rates are listed on Fertility Authority.

Donor egg in vitro fertilization may be an option for women over the age of 37 seeking pregnancy. Donor egg success rates correlate to the age of the donor, who is generally a woman younger than the recipient with adequate hormone levels. During a donor egg in vitro cycle, the donors ovaries will be stimulated to produce multiple follicles containing eggs. They will be surgically retrieved, fertilized in the lab and returned to the recipients’ uterus.

If you would like a referral to a provider in your area which can evaluate your unique situation and advise the best course of action to a successful pregnancy one of our Patient Care Advocates will be happy to help.